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Home My WebLink About0500 OCEAN STREET (62) 0 o C> C>CCa-gin ��- TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # Health Division Date Issued Y f I� Conservation Division Application Fee �. Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Uftt P/7 a. ( � Village "-/,-7 r)/?J,� Owner Address o?706 /U, A / A � 100 Al Telephone Dorf- U-� �L Permit Request Square feet: 1 st floor: existing5oproposed -2nd floor: existing proposed iumtal new Zoning District Flood Plain Groundwater Overlay Project Valuation -NL`)CQ o° Construction Type wm �. a Lot Size 0 Grandfathered: ❑Yes ❑ No If yes, attach'supporting�ceocumentation. Dwelling Type: Single Family. d Two Family ❑ Multi-Family (# units) Age of Existing Structure � � Historic House: ❑Yes M No On Old King'S"Highway��• ❑Y;e5 ANo_ Basement Type: a<ull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) ��,362 Number of Baths: Full: existing_ new Half: existing new jPr — Number of Bedrooms: —s� existing �?new Total Room Count (not including baths): existing & new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil $Electric ❑ Other Central Air: ❑Yes Oo Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existiw❑ new size_Pool: ❑ exis ❑ new size _ Barn: ❑ existi ❑ new size_ Attached garage: ❑ exist i ❑ new size _Shed: ❑ existiK70 new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial �d Yes ❑ No If yes, site plan review# o Current Use �� d e-) Proposed Use 4� APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Namege� LO—Qc"c__� Telephone Number 5_S -p7 G 5 Address I( C Q !i jam_ 20C License # CS— 0� 5 0 9 11 LQ MG 6- 2_(DZJ 2 Home Improvement Contractor# OO 1 Email OE4C,!� C7_-e 0!') f Q /JQ(2 , l 60) 'Worker's Compensation # C F'ltOe-0 00 gSS),44� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE_ .. DATE f FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED I MAP/PARCEL NO. I R ADDRESS VILLAGE OWNER -DATE OF-INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE : ELECTRICAL: ROUGH FINAL PLUMBING: . ROUGH FINAL GAS: ROUGH FINAL l FINAL BUILDING s D`RT CLOSED OUT `s r ASS:OQ�.)ATION PLAN NO. "e The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 . www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Auplicant Information Please Print Lezibly Name(Business/Organization/Individual): Oc.(p- .,.-C-`, }e' P, Address: Tho o or) City/State/Zip: Q2 Phone#: EOT5 Are you an employer?Check the appropriate box: Type of project(required): 1. G I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp.insurance comp. insurance.I required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof rep insurance required.]t c. 152, §1(4),and we have no 130ther 1 t�L® employees. [No workers' comp.insurance required.] 40 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and jab site information. Insurance Company Name: �p _� Policy#or Self-ins.Lic.#: l_ C� U � 1'q Expiration Date: 1 Job Site Address: U� City/State/Zip: '" I Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration da4-z(oc Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi u er lh a and penalties ofperjury that the in formation provided above is true and correet. Sim re Date: Phone#: �� -7 1 11 C) Official use only. Do not;wIte in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building.Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Client#:586925 20CEANSIDEIN ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) 01/3112014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Dowling&O'Neil Pkc°NE e Ext;508 775-1620 ac Nc: 5087781218 Insurance Agency E-MAIL ADDRESS: 973 lyannough Rd., PO Box 1990 INSURER(S)AFFORDING COVERAGE NAIC# Hyannis,MA 02601 INSURER A:Arbella Insurance Company INSURED Oceanside,Inc. INSURER B;Everest National Insurance Comp 217 Thornton Drive INSURERC;Safety Insurance Company Hyannis,MA 02601 INSURER D: INSURER E; INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE ADD y yp POLICY NUMBER MMIDIDY� MMIDDYIYEYrr LIMITS A GENERAL LIABILITY 8500061423 D110112014 01101/2011 EEACH�OC7CURRENCE $1 000,000 X COMMERCIAL GENERAL LIABILITY PREMISES REoecTurence $100 0OO CLAIMS PAAOE OCCUR MED EXP(Any one person) $5 000 PERSONAL&ADV INJURY $1 000 000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $2,000,000 POLICY F jE Q LOC $ C AUTOMOBILE LIABILITY 2434628 01/0112014 01101/201 COMBINED SINGLE LIMIT Eaaccid.nl $1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OS X AUTOS SCHEDULED BODILY INJURY(Per acddent) $ AUTOS X HIRED AUTOS, X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ A X UMBRELLALIA6 X OCCUR 4600061424 01/01/2014 01/011201 EACH OCCURRENCE $2000000 EXCESS LIAR CLAIMS-MADE AGGREGATE $2 000 000 DEb I X RETENTION 10000 $ B WORKERS COMPENSATION BINDER369533 01/0112014 01/011120115 X WCSTATU- OTH- AND EMPLOYERS'LIABILITYIER ANY PROPRIETORIPARTNERIEXECUTIVE Y/N N E.L.EACH ACCIDENT $1 00O 000 OFFICERIMEMBER EXCLUtlED9 NIA A (Mandatory in NH) E.L,DISEASE-EA EMPLOYEE $1 000 000 If yas,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1 000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedula,if more space le required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVES 01988.2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S1240761M124075 KKM Massacli'us*etts Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License-, CS-073097 PETER A LAROCE 18 CEDRIC ROAD Centerville NM 02632 -xpiraTidn a ir.;ssir.ner 11/03/2014 R flice of Consumer Affairs& Business:Regulation ME=IMPR0Vt -,CONTRACTOR eglstratlt5 �--. Explra7= - ` (V' Supplement OCEAN810E, INC PETER LAROGHE � - 217 Thornton Dr �`2 : elf use, Hyannis;MA 02601 - Undersecretary r License or registration valid for mdividul use only before the expiration,date. if found'.return to:. Office of Consumer Affairs.And Business Regulation 10 Park Plaza-Suite 5176 •ard. Boston,MA 0211E Not valid without signature Yachismran Condominium Trust Board of Trustees 500 Ocean Street Hyannis,MA 02601 DATE: March 14, 2014 RE: Units 147, 148, 149, 150,Yachtsman Condominium Trust, 500 Ocean Street, Hyannis To the Town of Barnstable Building Commissioner, The Board of Trustees for the Yachtsman Condominium Trust voted and approved Oceanside, Inc. to perform work as is delineated in the request we received from the Unit Owners. This letter serves as notice of that vote to approve Oceanside, Inc. which has been noted in the Minutes of the Board Meeting. Signed Under the Pains and Penalties of Perjury this 0 day of A�� , 20 i )Boa ry, of Trustesman Con ominium Trustcean Street (c/o Manager's Office) Hyannis, MA 02601 Enc./File Unit 147 -basement 111.6.6/Z__s � y LZ"_4 1-3' 10" 4 = 5'8" . 8' 10" 0 m tM, zo 12' GI basement 20140025 YACHTSMAN 3/19/2014 Page: 1 Unit 147 -Main Level / � �- c Vp 31 3'5" 50 Living Room 4" { CV I-4'4' v N N Aining Room. ZD r lit 9,1 io F- -� Kitchen L CN T f—6'9". T 59 _ M 5'$,. 0 U Main Level 20140025 YACHTSMAN 3/19/2014 Page: 2 THE RIGHT CHOICE Sill-cc 1971 j d�01I se Only 1 IfJOB NUMBER ceansdez I� �. , , • �+ MR � u a Resto -rat, on 217Thornton Drive,Hyannis,Mass.02601 508-771-3110 800-464-3318(MA.Only),774-470-2211 Fax ASSIGNMENT AND AUTHORIZATION TO PAY The undersigned, herein called claimant, has authorized and ordered from Oceanside, Inc. , the materials and/or services requested. Undersigned hereby assigns to Oceanside, Inc. any unpaid proceeds due or to become due, _ under the claimant ' s policy with the insurance company to pay direct to Oceanside, Inc. or to include its name on a check or draft, for all requested work. In the event that Oceanside ' s claim herein is not covered by, or paid by, an insurance company, claimant agrees to pay Oceanside, Inc. within sixty (60) days after work has been completed. Claimant understands that Oceanside, Inc. is working for them and not the insurance company or the adjuster. Payments remaining due and payable after the claimant has received payment from the insurance company shall bear interest at one and one- half (1-1/20) percent per month. In the event that there is a breach by the claimant of any of the conditions of this agreement, Oceanside, Inc. shall be entitled to recover, as additional damages, attorneys ' fees, costs and any other collection expenses reasonable and attributable to said breach. If payment is not received within 60 days, collection action will commence without further notice to the claimant . LOSS/DAMAGE ADDRESS 2_5� MAILING ADDRESS (BILLING) CITY STATE ZIP INSURANCE ADJUSTER' S NAME/CO. LOCAL NSURANCE AGENCY NAM N NAME INS. CAR IER/POLICY UNDERWRITER DATE: -' \Sd�,AIMANT I S S IGNAT PHONE:��.,�• ��/' ,L 19 EMAIL: (/ 4A